Individual provider Active NPI

Kiersten M Moreno, M.D.

  • Obstetrics & Gynecology Physician
  • Independence, MO
National Provider Identifier
1114281730
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2016019195 Issued in MO
Practice address
19500 E 39TH Street
Suite 300
Independence, MO 64057-8324
Phone
(816) 478-0220
Fax
(816) 795-3456
NPI assigned
Jun 28, 2012
Last updated
Jul 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2016019195 MO Primary

Addresses

Primary practice location

19500 E 39TH Street
Suite 300
Independence, MO 64057-8324

Mailing address

19500 E 39TH Street
Suite 300
Independence, MO 64057-8324
Phone (816) 478-0220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kiersten.Moreno@digichart.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804000755 MO Practitioner - Obstetrics/Gynecology 0345546057 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Womens Clinic PCGroup PAC ID 2062958119, 8 clinicians

Practice addresses (Care Compare)

19550 E 39TH St S
Independence, MO 64057-2306
Phone (816) 478-0220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016019195MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince May 22, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 22, 2021 Accepting new patients
Independence Womens Clinic PC Obstetrics & Gynecology CurrentSince Jul 1, 2024 Accepting new patients
Midwest Division - LRHC LLC CurrentSince Aug 15, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 22, 2021 Accepting new patients
Centerpoint Medical Center of Independence, LLC Past Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

3401 Pine St
Higginsville, MO 64037
Phone (660) 548-2192

19550 E 39th St S
Ste 300
Independence, MO 64057
Phone (816) 478-0220

1500 State St
Lexington, MO 64067
Phone (660) 259-2203

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCDJDD/Endpoint/HCDJDD
  • Direct secure messaging: kiersten.moreno@digichart.direct-ci.com
  • Direct secure messaging: kiersten.moreno@hca2.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1114281730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 E 39TH STREET",
            "address_2": "SUITE 300",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640578324",
            "telephone_number": "816-478-0220",
            "fax_number": "816-795-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 E 39TH STREET",
            "address_2": "SUITE 300",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640578324",
            "telephone_number": "816-478-0220",
            "fax_number": "816-795-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "KIERSTEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2016019195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kiersten.Moreno@digichart.direct-ci.com",
            "affiliation": "N",
            "address_1": "19500 E 39th Street",
            "address_2": "Suite 300",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640578324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.